Vitamin D for the management of asthma

Martineau, Adrian R.; Cates, Christopher J; Urashima, Mitsuyoshi; Jensen, Megan E.; Griffiths, Alex; Nurmatov, Ulugbek; Sheikh, Aziz; Griffiths, Chris

doi:10.1002/14651858.cd011511.pub2

Cited by 153 publications

(173 citation statements)

References 65 publications

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“…Vitamin D deficiency has been associated with the asthma epidemic, obesity in African Americans, westernization of countries with higher-risk populations for asthma, increased airway hyperresponsiveness, lower pulmonary functions, worse asthma control, and possibly steroid resistance [20]. People given vitamin D supplement had fewer asthma attacks needing treatment with oral steroids [21]. The average number of asthma attacks per person per year decreased from 0.44 to 0.28 with vitamin D [21].…”

Section: Introductionmentioning

confidence: 99%

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Serum Vitamin D Levels and Vitamin D Supplement in Adult Patients with Asthma Exacerbation

et al. 2016

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Introduction. Vitamin D deficiency has been linked to an increased risk of asthma exacerbations. Objective. This study aimed to compare vitamin D status during the period of severe asthma exacerbations and investigate if vitamin D supplementation improves asthma control. Methods. A total of 47 asthmatic patients and 40 healthy subjects participated in this study. Serum 25-hydroxyvitamin D (25(OH)D), asthma control test (ACT) score, and % predicted peak expiratory flow rate were evaluated in the period with and without severe asthma exacerbations. After that, we provided vitamin D2 supplements to the patients with low vitamin D levels for 3 months. Results. At the period of asthma exacerbation, the prevalence of vitamin D deficiency and insufficiency was 38.29% and 34.04%. There was no significant difference in the levels of serum 25(OH)D with and without asthma exacerbations but the levels were significantly higher in the healthy group. Serum 25(OH)D levels significantly correlated with ACT score. Moreover, vitamin D2 supplementation improved asthma control in uncontrolled asthma group. Conclusions. Hypovitaminosis D was common in asthmatic patients but was not the leading cause of asthma exacerbations. Serum 25(OH)D levels correlated with the ability to control asthma. Improving vitamin D status might be a benefit in uncontrolled asthmatic patients.

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Section: Introductionmentioning

confidence: 99%

“…People given vitamin D supplement had fewer asthma attacks needing treatment with oral steroids [21]. The average number of asthma attacks per person per year decreased from 0.44 to 0.28 with vitamin D [21]. Vitamin D reduced the risk of attending hospital with acute exacerbation asthma from 6 per 100 to around 3 per 100 [21].…”

Section: Introductionmentioning

confidence: 99%

Serum Vitamin D Levels and Vitamin D Supplement in Adult Patients with Asthma Exacerbation

et al. 2016

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“…Alternative explanations include a failure to affect behaviours that trigger consultations during asthma exacerbations, or a failure to address biomedical factors that might affect asthma control. Vitamin D deficiency is common in south Asian groups in east London[41] (90% insufficient, 50% deficient), which may contribute to poor asthma control and increased risk of exacerbation,[42, 43] potentially rendering behavioural interventions less effective. Further work should address these factors.…”

Section: Discussionmentioning

confidence: 99%

Effect of an Education Programme for South Asians with Asthma and Their Clinicians: A Cluster Randomised Controlled Trial (OEDIPUS)

et al. 2016

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BackgroundPeople with asthma from ethnic minority groups experience significant morbidity. Culturally-specific interventions to reduce asthma morbidity are rare. We tested the hypothesis that a culturally-specific education programme, adapted from promising theory-based interventions developed in the USA, would reduce unscheduled care for South Asians with asthma in the UK.MethodsA cluster randomised controlled trial, set in two east London boroughs. 105 of 107 eligible general practices were randomised to usual care or the education programme. Participants were south Asians with asthma aged 3 years and older with recent unscheduled care. The programme had two components: the Physician Asthma Care Education (PACE) programme and the Chronic Disease Self Management Programme (CDSMP), targeted at clinicians and patients with asthma respectively. Both were culturally adapted for south Asians with asthma. Specialist nurses, and primary care teams from intervention practices were trained using the PACE programme. South Asian participants attended an outpatient appointment; those registered with intervention practices received self-management training from PACE-trained specialist nurses, a follow-up appointment with PACE-trained primary care practices, and an invitation to attend the CDSMP. Patients from control practices received usual care. Primary outcome was unscheduled care.Findings375 south Asians with asthma from 84 general practices took part, 183 registered with intervention practices and 192 with control practices. Primary outcome data were available for 358/375 (95.5%) of participants. The intervention had no effect on time to first unscheduled attendance for asthma (Adjusted Hazard Ratio AHR = 1.19 95% CI 0.92 to 1.53). Time to first review in primary care was reduced (AHR = 2.22, (1.67 to 2.95). Asthma-related quality of life and self-efficacy were improved at 3 months (adjusted mean difference -2.56, (-3.89 to -1.24); 0.44, (0.05 to 0.82) respectively.ConclusionsA multi-component education programme adapted for south Asians with asthma did not reduce unscheduled care but did improve follow-up in primary care, self-efficacy and quality of life. More effective interventions are needed for south Asians with asthma.

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“…[18] A Cochrane meta-analysis recently showed that vitamin D supplementation does reduce the risk of severe exacerbations, and improves asthma symptom control in people with mild to moderate asthma. [19] Vitamin D and chronic obstructive pulmonary disease Low serum 25(OH)D 3 levels have been associated with lower forced expiratory volume in 1 second (FEV1), impaired immunological control, and increased airway inflammation. [20,21] Many patients with chronic obstructive pulmonary disease (COPD) have a vitamin D deficiency, and therefore the effects of vitamin D supplementation may extend beyond preventing osteoporosis.…”

Section: Asthma and Vitamin D Levelsmentioning

confidence: 99%

Vitamin D in respiratory diseases

Mahomed

2017

S Afr Res J

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REVIEWVitamin D has traditionally been known for its role in bone homeostasis with its effects on calcium and phosphate absorption and secretion. However, new evidence is emerging of its effects on a number of other cells, especially the immune system. This article reviews the role of vitamin D as it pertains to the respiratory tract and respiratory diseases. Respir J 2017;23 (1) Vitamin D belongs to a group of fat-soluble secosteroids and is required for intestinal absorption of calcium (Ca 2+ ) and phosphate (PO 4 3-). In humans, vitamin D is present as ergocalciferol (vitamin D 2 ) or cholecalciferol (vitamin D 3 ), and both forms can be ingested from the diet and/or supplements. The body can also synthesise vitamin D from cholesterol when sun exposure is adequate, hence it has been nicknamed the 'sunshine vitamin' . [1] Recently, interest has grown in the role of vitamin D in many non-skeletal medical conditions, including respiratory infection and lung function. [2] Emerging evidence indicates that vitamin D-mediated innate immunity is important in host defences against respiratory tract pathogens. [3] Observational studies suggest that vitamin D deficiency increases the risk of respiratory infections, incident wheezing illness in children and adults, and can cause asthma exacerbations. Vitamin D also modulates regulatory T-cell function and interleukin-10 (IL-10) production, which may increase the therapeutic response to glucocorticoids in steroid-resistant asthma. S Afr HistoryIn 1914, American researchers McCollum and Davis discovered a substance in cod liver oil which was later called 'vitamin A' . In 1922, McCollum tested modified cod liver oil in which the vitamin A had been denatured. The modified oil cured rickets in sick dogs, so McCollum concluded the factor in cod liver oil that cured rickets was distinct from vitamin A. He called it vitamin D because it was the fourth vitamin to be named. [4] In 1923, American biochemist Harry Steenbock demonstrated that the irradiation of foodstuffs, especially milk, led to a cure for rickets. In 1932, an academic collaboration between Bourdillon, Rosenheim, King and Callow led to the isolation and characterisation of vitamin D and later in the 1930s, Windaus further clarified the chemical structure of vitamin D. By 1972, Holick had discovered that vitamin D was metabolised to two active forms, i.e. calcidiol and calcitriol. [5,6] Recommended dietary allowance of vitamin DThe US Institute of Medicine (IOM) recommended dietary allowance of vitamin D is 400 international units (IU) per day for children younger than 1 year of age, 600 IU per day for children at least 1 year of age and adults up to 70 years, and 800 IU per day for older adults.The US IOM concluded that serum 25-hydroxyvitamin D (25(OH)D) of 20 ng/mL or more would cover the requirements of 97.5% of the population. [7] The US Endocrine Society's Clinical Practice Guidelines suggest that 400 -1 000 IU/day may be needed for children aged <1 year, 600 -1 000 IU/day for children aged ≥1 year, and 1 500 ...

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Vitamin D for the management of asthma

Cited by 153 publications

References 65 publications

Serum Vitamin D Levels and Vitamin D Supplement in Adult Patients with Asthma Exacerbation

Serum Vitamin D Levels and Vitamin D Supplement in Adult Patients with Asthma Exacerbation

Effect of an Education Programme for South Asians with Asthma and Their Clinicians: A Cluster Randomised Controlled Trial (OEDIPUS)

Vitamin D in respiratory diseases

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